苏芮 焦拥政 韩玉 杨正夫 寥星 谢雁鸣 范吉平

摘要：目的 以北京市某三甲中医医院为例，从服务效率、服务质量及安全性等方面筛选中医优势病种。方法 根据该中医医院的诊断相关分类（DRGs）数据，筛选各个疾病大类（MDC）中的常见病种，提取例均费用、例均住院日、抗生素使用率、用血率及死亡率5个方面的数值与三级综合医院平均值进行对比分析。结果 共筛选出27个常见病种，在服务效率、安全性及服务质量等方面均具有优势的病种3个，安全性优势病种14个，服务质量优势病种13个。结论 与三级综合医院相比，该医院多数常见病种的安全性和服务质量的优势都比较明显，但大多数常见病种住院日较长，患者例均费用较高，在服务效率方面无明显优势。

关键词：优势病种；诊断相关分类；中医医院；服务效率；安全性；服务质量

DOI：10.3969/j.issn.1005-5304.2018.02.003

中图分类号：R2-05 文献标识码：A 文章编号：1005-5304（2018）02-0011-04

Study on TCM Dominant Diseases Based on Diagnosis Related Groups Data

SU Rui1， JIAO Yong-zheng2， HAN Yu2， YANG Zheng-fu3， LIAO Xing4， XIE Yan-ming4， FAN Ji-ping3

1. Department of Medical Affairs， Beijing Traditional Chinese Medicine Hospital， Capital Medical University， Beijing 100010， China； 2. Department of Hospital Management， China Academy of Chinese Medical Sciences， Beijing 100700， China； 3. China Press of Traditional Chinese Medicine， Beijing 100013， China； 4. Institute of Basic Theory for Chinese Medicine， China Academy of Chinese Medical Sciences， Beijing 100700， China

Abstract： Objective To screen TCM dominant diseases from service efficiency， service quality and security by taking a three-A-grade TCM hospital as example. Methods According to the diagnosis related data of the TCM hospital， the common diseases in major disease categories （MDC） were screened out. Average cost of hospitalization， average hospitalization days， antibiotic use rates， blood use rates， and mortality rates were compared with the average level of tertiary general hospitals. Results Totally 27 common diseases were screened out. Three diseases had advantages in terms of service efficiency， security and service quality； 14 diseases had security advantage； 13 diseases had advantage in service quality. Conclusion Compared with three-A-grade general hospitals， most of the common diseases in the hospital has obvious advantages in security and service quality， but the average length of hospitalization in the hospital is longer， and the average cost of most of the common diseases is higher than the general hospital， without advantages in service efficiency.

Keywords： dominant diseases； DRGs； TCM hospitals； service efficiency； security； service quality

我国自2009年公立医院改革开始试点，至2015年县级公立中医医院综合改革全面推开，城市公立中醫医院综合改革试点工作进一步深入，公立医院改革已进入核心环节。与综合医院相比，公立中医医院消除以药补医机制面临的情况较为复杂，支付方式改革难

度更大，且缺乏相关经验可循。为加快推进分级诊疗制度建设，国务院和国家中医药管理局分别于2015年9月和11月分别发布了《国务院办公厅关于推进分级诊疗制度建设的指导意见》（国办发〔2015〕70号）及《关于同步推进公立中医医院综合改革的实……